Individual
LARAE TESSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
713 LEONARD ST N, WEST SALEM, WI 54669-1229
(608) 786-1600
Mailing address
713 LEONARD ST N, WEST SALEM, WI 54669-1229
(715) 897-3815
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5688-27
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000
N/A
—
Enumeration date
01/23/2020
Last updated
01/23/2020
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